The long term clinical results following valve replacement with Hancock and Carpentier-Edwards bioprostheses were compared between tow valve models and between tow groups totaling 249 patients who were discharged after valve replacement from 1976
to
1986. The two groups of patients were treated with nonrandomized fashion. Follow-up was 87% complete. Cummulative duration of follow-up was 1909 patient-years, with maximum follow-up duration of 15 years.
The actuarial survival for 122 patients with Hancock valves was 95*2% (* standard deviation) and 84*4% after 5 and 10 years of follow-up, respectively. Comparable figures for 127 patients undergoing valve replacement with Carpentier-Edwards
valves
were
87*3% and 76*4%, respectively(p= NS). The probability of freedom from structural valve deterioration after 5 and 10 years of follow-up was 97*2% and 60*6%, respectively, with Hancock valves and 97*2% and 55*7%, respectively, with
Carpentier-Edwards
valves(p= NS). Considering all 249 patients, multivariate(Coxmodel) regression revealed that ejection fraction was only significant predictor of structural valve deterioration. The probability of freedom from thromboembolism after 5 and 10 years
of
follow-up was 91*3% and 86*4%, respectively, with Hancock valves and 94*2% and 82*5%, respectively, with Carpentier-Edwards valves(p= NS). Hence more strict control of anticoagulation should be done on patients with left atrial factors.
In summary, there were no significant differences in actuarial survival rate and major valve related complications between tow valve models. These results suggests that its use should be confined to older patients or patients with a
contraindication of
anticoagulation. (Korean J Thoracic Cardiovas Surg 1994; 27:24-31)
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